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Wound dehiscence: outcome comparison for sutured and mesh reconstructed patients

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Abstract

Purpose

Treatment guidelines for abdominal wound dehiscence (WD) are lacking. The primary aim of the study was to compare suture to mesh repair in WD patients concerning incisional hernia incidence. Secondary aims were to compare recurrent WD, morbidity, mortality and long-term abdominal wall complaints.

Methods

A retrospective chart review of 46 consecutive patients operated for WD between January 2010 and August 2012 was conducted. Physical examination and a questionnaire enquiry were performed in January 2013.

Results

Six patients were treated by vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) before definitive closure. Three patients died early resulting in 23 patients closed by suture and 20 by mesh repair. Five sutured, but no mesh repair patients had recurrent WD (p = 0.051) with a mortality of 60 %. Finally, 18 sutured and 21 mesh repair patients were eligible for follow-up. The incidence of incisional hernia was higher for the sutured patients (53 vs. 5 %, p = 0.002), while mesh repair patients had a higher short-term morbidity rate (76 vs. 28 %, p = 0.004). Abdominal wall complaints were rare in both groups.

Conclusions

Suture of WD was afflicted with a high incidence of recurrent WD and incisional hernia formation. Mesh repair overcomes these problems at the cost of more wound complications. VAWCM seems to be an alternative for treating contaminated patients until definitive closure is possible. Long-term abdominal wall complaints are uncommon after WD treatment.

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Conflict of interest

PP declares no conflict of interest. AM declares no conflict of interest. UP declares conflict of interest not directly related to the submitted work (honorarium for lectures arranged by KCI).

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Authors and Affiliations

  1. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

    P. Petersson

  2. Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, Lund, Sweden

    A. Montgomery & U. Petersson

  3. Department of Surgery, Skåne University Hospital Malmö, 205 02, Malmö, Sweden

    A. Montgomery & U. Petersson

Authors
  1. P. Petersson
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  2. A. Montgomery
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  3. U. Petersson
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Correspondence to U. Petersson.

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Petersson, P., Montgomery, A. & Petersson, U. Wound dehiscence: outcome comparison for sutured and mesh reconstructed patients. Hernia 18, 681–689 (2014). https://doi.org/10.1007/s10029-014-1268-y

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